Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1444 | OR |
NPI | 1013011030 |
---|---|
Provider Name | Dr. Paige Kimberly Warner |
First Address | Corvallis, OR 97330-6415 |
Second Address | Corvallis, OR 97330-6415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 08/07/2007 |